Page 28 - Practice
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Change of Service Provider under a Service Fee Billing Agreement: Customers who engage a Service
Provider and enter into a Service Fee Billing Agreement can change their Service Provider. The naming
of the new Service Provider requires completion of a new Service Fee Billing Agreement with the new
Service Provider.
Timing of Service Provider change effective dates: Due to some issues related to the timing of invoices,
UnitedHealthcare can only accept changes to the Service Provider under a Service Fee Billing Agreement
if notice is received by the UnitedHealthcare Commissions Unit before the customer’s next month billing
invoice is created. In most instances that occurs around the tenth day of the month prior to the month being
billed (for example, June 10 for a change that is effective July 1). If a request to change Service Providers is
received after the coming month’s billing invoice is created, the change in Service Providers will not occur for
two months (for example, a change request received September 20 will be effective November 1). System and
reporting issues prohibit us from making exceptions to these rules.
Customers who know they will be replacing their current Service Provider but who do not yet have a new
Service Provider or updated SFA documents can remove the current Service Provider before the billing
invoice is created without naming a replacement by notifying their sales representative of the upcoming
change. In such cases, we can install a new Service Provider starting in the month after the old Service
Provider was removed.
Assignment: An Agent of Record (AOR) may appoint another agent or agency (the assignee) to receive the
commissions on all of their cases through assignment. Such an assignment of commissions is irrevocable,
and all rights to further assignment of commissions on the assigned cases will be granted only to the
agent or agency to which the commissions are assigned. The assignee must be licensed and appointed by
UnitedHealthcare and legally able to receive commissions. We reserve the right to reject any request for
assignment. An agent may rescind their assignment at any time, but the rescission will only apply for cases
written after the effective date of the rescission.
Commissions differentiated by length of coverage: For commission structures that are differentiated by
the length of time the case has had coverage with us, “first year” commissions are paid for a period from the
original effective date up to the first renewal date. The commission rates for “subsequent years” or “renewal
years” are paid for all months starting on and following the first renewal date. The subsequent-year or
renewal-year commission classification will apply as long as the company has continuing coverage with any
of our subsidiaries, even if the policy undergoes a change in coverage, reinstatement, transfer to another
operating platform, is “spun-off” from a larger group or is transferred to another UnitedHealthcare or
UnitedHealth Group operating company.
Commissions differentiated by product: Commission schedules may apply to a specific product or set
of products within a product line. UnitedHealthcare has sole discretion to classify a product and assign
commission schedules to a product. The commission schedule for groups that convert from one product to
another will be changed at the time of the product conversion.
Government continuation policies: No commissions are paid on policies converted to individual policies
and certain government continuation policies.
Premium holiday: A premium holiday occurs when we eliminate the premium due in a month for a customer
or a group of customers. During a premium holiday the customer pays no money for their coverage for the
month but their coverage remains in force.
The following policies apply to the payment of commissions for a premium holiday:
1. Percent of Premium: A premium holiday means that no premium is paid for the month of the premium holiday.
Therefore, no commissions will be paid for cases where commissions are paid as a percent of premium.
2. Per Employee per Month (PEPM): Commissions will be paid for groups where the commissions are based
on the number of enrolled employees in the month. Even though no premium is paid, there is an active
enrolled employee count. Therefore, commissions will be paid in the usual manner for commission based
on a payment per employee per month.
MISSOURI AND SOUTHERN ILLINOIS 2017 Producer Performance Guide 28
Provider and enter into a Service Fee Billing Agreement can change their Service Provider. The naming
of the new Service Provider requires completion of a new Service Fee Billing Agreement with the new
Service Provider.
Timing of Service Provider change effective dates: Due to some issues related to the timing of invoices,
UnitedHealthcare can only accept changes to the Service Provider under a Service Fee Billing Agreement
if notice is received by the UnitedHealthcare Commissions Unit before the customer’s next month billing
invoice is created. In most instances that occurs around the tenth day of the month prior to the month being
billed (for example, June 10 for a change that is effective July 1). If a request to change Service Providers is
received after the coming month’s billing invoice is created, the change in Service Providers will not occur for
two months (for example, a change request received September 20 will be effective November 1). System and
reporting issues prohibit us from making exceptions to these rules.
Customers who know they will be replacing their current Service Provider but who do not yet have a new
Service Provider or updated SFA documents can remove the current Service Provider before the billing
invoice is created without naming a replacement by notifying their sales representative of the upcoming
change. In such cases, we can install a new Service Provider starting in the month after the old Service
Provider was removed.
Assignment: An Agent of Record (AOR) may appoint another agent or agency (the assignee) to receive the
commissions on all of their cases through assignment. Such an assignment of commissions is irrevocable,
and all rights to further assignment of commissions on the assigned cases will be granted only to the
agent or agency to which the commissions are assigned. The assignee must be licensed and appointed by
UnitedHealthcare and legally able to receive commissions. We reserve the right to reject any request for
assignment. An agent may rescind their assignment at any time, but the rescission will only apply for cases
written after the effective date of the rescission.
Commissions differentiated by length of coverage: For commission structures that are differentiated by
the length of time the case has had coverage with us, “first year” commissions are paid for a period from the
original effective date up to the first renewal date. The commission rates for “subsequent years” or “renewal
years” are paid for all months starting on and following the first renewal date. The subsequent-year or
renewal-year commission classification will apply as long as the company has continuing coverage with any
of our subsidiaries, even if the policy undergoes a change in coverage, reinstatement, transfer to another
operating platform, is “spun-off” from a larger group or is transferred to another UnitedHealthcare or
UnitedHealth Group operating company.
Commissions differentiated by product: Commission schedules may apply to a specific product or set
of products within a product line. UnitedHealthcare has sole discretion to classify a product and assign
commission schedules to a product. The commission schedule for groups that convert from one product to
another will be changed at the time of the product conversion.
Government continuation policies: No commissions are paid on policies converted to individual policies
and certain government continuation policies.
Premium holiday: A premium holiday occurs when we eliminate the premium due in a month for a customer
or a group of customers. During a premium holiday the customer pays no money for their coverage for the
month but their coverage remains in force.
The following policies apply to the payment of commissions for a premium holiday:
1. Percent of Premium: A premium holiday means that no premium is paid for the month of the premium holiday.
Therefore, no commissions will be paid for cases where commissions are paid as a percent of premium.
2. Per Employee per Month (PEPM): Commissions will be paid for groups where the commissions are based
on the number of enrolled employees in the month. Even though no premium is paid, there is an active
enrolled employee count. Therefore, commissions will be paid in the usual manner for commission based
on a payment per employee per month.
MISSOURI AND SOUTHERN ILLINOIS 2017 Producer Performance Guide 28
